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UNITED STATES OF AMERICA. 






AN ESSAY 



ON THE 



Causes of Infant Mortality; 



Being a brief account of the origin of the feebleness 

and diseases which afflict and destroy so many 

children under five years of age. 



— BY — 



JOHX W. THRAILKILL, M. D., 



!§f® itili^ Mm® 




ST. LOUIS: 

S. W. Book and Publishing Co., 510 Washington Avenue. 

1869. 






Entered, according to Act of Congress, in the year 1869, by 
JOHN W . THRAILKILL, 
In the Clerk's Office of the District Court of the United States in and for the 
Eastern District of Missouri. 



PREFACE. 

The articles of which this little work is composed 
originally appeared in the Sunday edition of the Missouri 
Republican. The author had no notion at the time they 
were written of ever putting them into the form of a book, 
but having been earnestly solicited to do so by numerous 
parties who read them as they first came out, at length 
consented, and now begs leave to present them to the pub- 
lic in this form. Some additions and corrections have 
been made to the articles, and they are submitted without 
an apology for thenumeros errors and imperfections with 
which they still abound, 

The articles are so brief as to be little more than an 
index to the great subject upon which they treat. But it 
is hoped that they may serve to stimulate thought and 
investigation in a quarter where they are most needed, 
and will do most good, namely — among parents, There 
are many parents who would willingly introduce reforms 
into the prevailing modes of managing their children if 
they could be convinced that there are better and more 
successful modes of treatment than have been handed 
down to them from their parents. But the power of 
education is so great in its influence over the conduct ot 
individuals and nations that it is next to an impossibility to 
convince people that any other way is better than the one 
they have been taught. The only way to introduce any 
given reform, in opposition to this prejudice of education, 
is to continually " agitate the question" — " keep it before 
the people." All reforms have been introduced in this 
way, and printers' ink is by all means the most successful 
mode of accomplishing this end. It is by the power of 
the printing press that the thoughts of the best and 
wisest of mankind are rapidly becoming the common 
property of all. 

The Author. 

No. 312 N. Sixth Street, St. Louis, Nov.,iS6o. 



CONTENTS. 



Preface Page 4 

ARTICLE I. 
Hereditary Causes of Infant Mortality 5 

ARTICLE II. 

Causes of Infant Mortality arising with the mother dur- 
ing Gestation 18 

ARTICLE III. 
The Extrinsic or Exciting Causes of Infant Mortality .... 21 

ARTICLE IV. 

Causes of Infant Mortality arising from the Mismanage- 
ment of Parents and Nurses 29 

ARTICLE V. 
Infant Mortality arising from such sources as should 

come within the Province of the Public Authorities.. 40 

ARTICLE VI. 

Causes of Infant Mortality arising from the Mismanage- 
ment of Physicians • - • • 49 

A Treatise on the Physiological Management of Infancy 

and Childhood 61 



ON THE 

CAUSES OF INFANT MORTALITY. 



ARTICLE I. 



I noticed in the Republican of the 8th inst. " A 
Challenge to the Medical Faculty," by Chas. Mil- 
ler, F. H. Gerhold and others. The principal pro- 
position contained in this " challenge" is a de- 
mand upon the medical faculty to explain " the 
wherefore of such an alarming death-rate among 
children, and why the boasted science of the med- 
ical^ profession does or can do nothing." Such a 
demand on the part of the people is perfectly 
rational and legitimate, and should be responded 
to by the profession with that alacrity which has 
ever distinguished them as the philanthropic con- 
servators of the public weal. The importance of 
the subject can not be over-estimated. It involves 
the dearest interests of the race, and demands the 
attentive and earnest consideration of all. The 
limits of a newspaper article will permit nothing 
but the briefest possible consideration of the sub- 
ject; hence I shall enter at once upon the main 
topics without further preliminaries. 



6 AN ESSAY ON THE 

The statement is made in the above mentioned 
challenge "that about forty per cent, of all the 
deaths are children under five years." It would 
be foreign to my purpose either to substantiate or 
call in question the truth of this statement. Be- 
sides, such an inquiry would be barren of practi- 
cal results, because its approximation to the truth 
will be admitted by all intelligent observers. 

It can not be possible that so large an infant 
mortality is the order of Providence, and that its 
causes are beyond the control of society. Such a 
view would necessarily lead to fatalism — a doc- 
trine refuted by the every-day experience of all. 
If this be a scheme of Providence, why trouble 
ourselves about His affairs ? Why believe in the 
utility of sanitary arrangements or the efficacy of 
remedial measures ? If the Divine Being has the 
matter under his immediate supervision, and it is 
his will that so large a portion of the race shall per- 
ish in infancy, man is thereby relieved of all respon- 
sibility in the matter. Not only this, but he is 
deprived of all power to modify the result, either 
for the better or worse, and his attempt to do so 
is an impious effort to act in defiance of the will 
of the Creator. If this be the order of Providence 
it is obviously our duty to piously close our eyes, 
fold our arms, and be resigned to His will. But 
if, on the other hand, man is a free agent and an 
accountable being, responsible for the manner in 
which he uses the talents intrusted to his care, 
and capable of modifying the conditions of nature 
with which he is surrounded for the promotion of 



CAUSES OF INFANT MORTALITY. < 

his own happiness and that of his fellow-crea- 
tures, then it must be evident to all that the well- 
being of infancy depends, in a great measure, 
upon the treatment it receives at his hands, and 
that he becomes accountable for all the suffering 
arising from his ignorance and mismanagement. 
Whether man is morally culpable for pursuing a 
wrong mode of treatment because he is ignorant 
that it is such, is a question I shall leave for phi- 
losophers to decide. But the physical suffering of 
the young being arising from such mismanage- 
ment is precisely the same, whether it arise from 
ignorance or a willful infliction of those having 
charge of it. For example : If a parent admin- 
ister to her child any given drug which she be- 
lieves to be innocent, but which proves to be poi- 
sonous to it, its sufferings are none the less on ac- 
count of her ignorance, but precisely the same as 
if she had given it with intent to destroy its life. 
No intelligent being will for a moment contend 
that sickness and death can be wholly banished 
from infancy by any system of management 
which man, in his present state of enlightenment, 
can adopt ; for the seeds of early decay are often 
sown by parents even of the third and fourth gen- 
erations, and they will necessarily, in some in- 
stances, ripen into a harvest of disease and death, 
despite the most favorable influences and the best 
treatment. Besides, accidental infringements of 
the laws of health will necessarily occur some- 
times to the most enlightened and experienced in- 
dividuals. 



AN ESSAY ON THE 



"The successful rearing of every living being," 
says Dr. Combe, "depends chiefly on the proper 
adaptation of its treatment to the laws of its con- 
stitution. Where these are in harmony, the fail- 
ures will be few and unimportant, and arise chiefly 
from those unavoidable accidents and exposures 
to which all created beings are, and will continue 
to be, more or less subjected. But where the treat- 
ment and laws are not in harmony, failure, dis- 
ease and ultimate death may be expected as the 
most frequent and certain results." 

The causes which affect the health and life of 
infancy will be considered under three distinct 
heads, viz. : 

First, Hereditary, or those constitutional pecu- 
liarities derived from both parents, and supposed 
to have their origin at the time of conception. 

Secondly, Materxal, or those derived from the 
mother during gestation. 

Thirdly, Extrinsic, or those acting on the child 
from without, after its birth. 

HEREDITARY CAUSES. 

Hereditary causes play a very important part 
in the production of infant mortality. Puny pa- 
rents, or those weak in vitality, can not beget vig- 
orous offspring. "Like begets like." No fact is 
more patent than that many children are born so 
feeble in constitution as to be swept out of exist- 
ence by the slightest causes. Every physician of 
experience must have noticed how difficult it is to 
restore the sick children of some parents, com- 



CAUSES OF INFANT MORTALITY, 9 

pared with others, and how they often perish from 
causes so slight as to make no impression on 
others more favored in hereditary constitution. 
Indeed, every judicious physician forms his prog- 
nosis of a sick child, in a great measure, from the 
temperaments or physical aspect of the parents. 

The various conditions of parents affecting the 
health and vigor of offspring are : 

" First. Natural infirmities of constitution de- 
rived from their own parents. 

" Secondly. Premature marriages, especially of 
delicate females, and persons strongly predisposed 
to hereditary disease. 

" Thirdly. Marriages between parties too 
nearly allied in blood, particularly where either 
of them is descended from an unhealthy race. 

" Fourthly. Great disproportion in age be- 
tween the parents. 

" Fifthly. The state of the parents at the time 
of conception."* 

Sixthly. Incompatibility of temperaments be- 
tween the parents. 

These may seem a numerous and formidable 
array of disqualifications in parents to beget 
healthy offspring ; nevertheless, tliey each con- 
tribute in a very important degree to the produc- 
tion of that delicacy and feebleness of constitu- 
tion so extensively prevalent everywhere amongst 
children, which render them so susceptible of 
every extrinsic source of disease, and so unable 
to bear up under its ravages. The transmission 

*Combe on ' ' Infancy, " p 55, et seq. 



10 AN ESSAY ON THE 

from parent to child of the tendency to the more 
obvious forms of constitutional disease, such as 
consumption, scrofula, insanity, &c, is univer- 
sally recognized. Indeed, the fact is so patent, 
and the knowledge of it so universal, that all man- 
kind must have known it without the aid of reve- 
lation. K"o one afflicted with any one of these 
diseases should ever become a parent ; and those in 
whom such constitutional tendency exists should 
select healthy partners of a different tempera- 
ment. 

If the tendency to any given disease exists in 
JbotJi parents, it will be doubled in the offspring, 
and they will be likely to fall an early prey to it. 
It is in this way that consumption has become so 
prevalent and fatal amongst us. The seeds of 
death are thus continually sown by parents, as 
tares among wheat, and they come forth and yield 
an abundant harvest. The spare, thin-breasted 
youth falls in love with the hectic flush on the 
delicate maiden's cheek, and they become united 
into one being, and their children, one after an- 
other, descend into the grave before they are able 
to call their parents' name ; or if they live to grow 
up and propagate their kind, it is but to sow the 
seeds of disease and death and people the grave- 
yard with little graves. 

Early marriages, before the parties have at- 
tained complete growth, is a frequent source of 
delicacy and disease in infancy. It is often the 
case that the first children of such parents are fee- 
bl e, decay and die, while others, begotten after 



CAUSES OF INI ANT MORTALITY. 11 

maturity is attained, are healthy. Besides, early 
marriages are one of the most prolific sources of 
early decay and premature old age in our Ameri- 
can women. A girl married at fifteen will be 
older in physical decay, health and beauty at 
thirty than one married at twenty will be at for- 
ty-five, cceteris paribus. 

Great disparity of years in tlie parents is often 
a source of imperfection in offspring. The off- 
spring of old men and young wives rarely attain 
great age, and are frequently subject to lingering 
infirmities. 

Tlie state of parental health at the time of con- 
ception has a greater influence on the future off- 
spring than is generally imagined. It is doubtless 
the case that many children owe their constitu- 
tional infirmities to some acquired or temporary 
infirmity of one or both parents existing at the 
time of conception. Quite a number of well au- 
thenticated cases of idiocy and insanity have been 
reported as having occurred in children as the re- 
sult of a drunken debauch on the part of gener- 
ally temperate fathers ; and if the unwritten 
records of sin could be traced they would doubt- 
less exhibit many cases of the kind. 

" A stronger motive to regularity of living, and 
moderation in passion," says Dr. Combe, " can 
scarcely be presented to a right-minded parent 
than the simple statement of their permanent in- 
fluence on his future offspring. Many a father 
has grieved over, and perhaps resented, the dis- 
tressing and irreclaimable follies of a wayward 



12 AN ESSAY ON THE 

son without suspecting that they actually derived 
their origin from some forgotten irregularity of 
his own." Children begotten by parents while in 
a state of debility from great mental anxiety, 
from cares and troubles, or some harassing bodily 
ailment, are generally peevish, irritable, ill-na- 
tured, and very susceptible of every extrinsic 
source of disease. Such children are very liable 
to convulsions — one of the most frequent and fear- 
ful sources of infant mortality. But this is only 
one of a legion of ills arising from the same 
source. 

The source of much infant mortality has its ori- 
gin in incompatibility of temperament in tlie pa- 
rents. Prof. W. Byrd Powell deserves the lasting 
gratitude of mankind for discovering and eluci- 
dating this fact. I know of many instances of 
man and wife so incompatible as to be either 
wholly unable to reproduce living children, or if 
they are viable at all, they live to an inheritance 
of disease and sufiering, while the parents them- 
selves are sound in constitution and enjoy good 
health. Two persons, both of whom have a lym- 
phatic temperament, should never become man 
and wife if they desire healthy offspring. If the 
temperament be strongly marked the chances are 
that they will have no living children ; but if it 
be partial they may live for a time. The same 
injunction is applicable to those having a cephalic 
or nervous temperament. The character of the 
diseases, however, to which the offspring will be 
subject, will vary somewhat as does the tempera- 



CAUSES OF INFANT MORTALITY. 1 : > 

ment of the parents. Lymphatic parents gener- 
ally produce scrofulous children, and those in 
whom the nervous temperament predominates will 
produce those more subject to disease of the brain 
and nervous system. Persons possessed of either 
of these temperaments in a marked degree should 
select partners of a different one if they desire 
viable and healthy offspring. 

My next paper will be on the causes of infant 
mortality originating with the mother during ges- 
tation. 



ARTICLE II. 



MATERNAL CAUSES, OR THOSE ARISING WITH THE 
MOTHER DURING GESTATION. 

Having briefly considered in my last paper the 
hereditary causes of infant mortality, the sec- 
ond division of the subject — the maternal, or 
those brought to bear on the child through the 
maternal system during gestation — demand con- 
sideration, as scarcely less important. Upon the 
mother, much more than the father, depend the 
health and vigor of offspring. The ancient Spar- 
tans recognized the importance of this fact, and 
bestowed especial pains on the education of their 
daughters. When a foreign woman said to Gor- 
go, the wife of Leonidas, " You Spartan women 
are the only women in the world who rule the 
men," Gorgo replied, " We are the only women 
that bring forth men" Lycurgus, their great 



14 AN ESSAY ON THE 

law-giver, believed the education of the youth to 
be the most glorious work of the rulers of the 
State. He began, accordingly, by regulating mar- 
riages with reference to physical adaptability, in 
order to insure to the coming generation a healthy 
physical organization as a solid foundation upon 
which to build the prosperity of the State. " He 
ordered the virgins to exercise themselves in run- 
ning, wrestling and throwing quoits and darts ; 
that their bodies being strong and vigorous, the 
children afterward produced from them might be 
the same, and that, thus fortified by exercise, they 
might the better support the pangs of child-birth 
and be delivered with safety." 

The health and character of the future offspring 
are greatly influenced by the conduct of the 
mother during carriage. Great numbers of child- 
ren die from causes originating during this time. 
One of the most striking instances on record illus- 
trating the truth of this fact is recorded in the 
Dictionnaire des Sciences Medicates, on the au- 
thority of Baron Percy, an eminent French mili- 
tary surgeon and professor, "as having occurred 
after the siege of Landau, in 1793. In addition 
to a violent cannonading, which kept the women 
for some time in a constant state of alarm, the ar- 
senal blew up with a terrific explosion, which few 
could listen to with unshaken nerves. Out of 
ninety-two children born in the district within a 
few months afterward, Baron Percy states that 
sixteen" died at the instant of birth ; thiety- 
theee languished for froifi. eight to ten months, 



CAUSES OF INFANT MORTALITY. 15 

and then died ; eight became idiotic, and died be- 
fore the age of live years; and two came into the 
world with numerous fractures of the bones of 
the limbs, caused by the convulsive starts in the 
mother excited by the cannonading and explosion ! 
Here, then, is a total of fifty-nine children out of 
ninety-two, or within a trifle of two out of every 
three, actually killed through the medium of the 
mother's alarm and its natural consequences upon 
her own organization." This is, indeed, a striking 
example, and perhaps but few such occur ; but it 
forcibly illustrates the influence of the mental 
emotions of the mother upon the unborn child, 
and suggests the necessity of avoiding every 
cause calculated to disturb the equilibrium of her 
mind. Doubtless many children perish, or are 
rendered invalids for life, by domestic bombard- 
ments, cannonadings and explosions, confined 
within the four walls of home and unknown to 
the outside world. Connubial infelicity, social 
discord, misfortunes and the various accidents to 
life and limb to which all are more or less liable, 
frequently subject the prospective mother to bit- 
ter griefs, heart-rending anxieties, terrible frights 
and wild alarms, all of which have a deleterious 
influence on the developing infant. It is highly 
probable that all violations of the laws of health 
affecting the mother during this time produce 
similar effects on the young being she carries ; 
disturbing its healthy development or entailing 
on it lasting infirmities, according to the magni- 
tude or persistence of the parental offense. Al- 



16 AN ESSAY ON THE 

though, the evil effects of such parental infringe- 
ments may not be obviously manifested in the in- 
fant after its birth, we should not, on that account, 
conclude that they have had no deleterious effect ; 
for the constitutional vigor of the infant may be 
impaired, and doubtless is, in many cases, in an 
imperceptible degree, yet sufficient to render it 
less capable of resisting the extrinsic sources of 
disease, and less able to withstand its attacks. 

There are many women, alas ! very many, who 
live in habitual disobedience to the laws of health. 
A vast majority of them do so from sheer ignor- 
ance, never having been educated in that most im- 
portant of all sciences — physiology. On account 
of this general ignorance, the habits and customs 
of society are not formed and sustained from any 
just conception of their appropriateness to the 
preservation of life, health and longevity ; for 
these things are rarely thought of until they be- 
come imperiled. Many of the most detrimental 
habits of society are conceived in ignorance, 
brought forth in fashion, and nurtured in indo- 
lence and dissipation. Women, in the condition 
of which I am treating, are frequent sufferers from 
these unpliysiological habits, some of them being 
peculiar to the sex. While in this condition she 
is more susceptible of the evil consequences of 
bad habits ; and she becomes sickly from causes, 
the influence of which she is able at other times 
to resist without any marked deterioration of her 
health. This is due to the fact that all the ener- 
gies of her being are required at this time in the 



CAUSES OF [NFANT MORTALITY. 17 

development of her offspring, and none are left 

with which to combat the evil effects of bad 
habits. 

I will now enumerate and briefly discuss a few 
of the most common infringements of the laws of 
health — those from which women, during gesta- 
tion, most frequently suffer, and bring consequent 
disease upon their offspring, namely : 

Irregularity in habits of eating and sleeping. 
This is more frequently exemplified among the 
rich and fashionable, the opera-goers, and those 
inordinate lovers of admiration who make and 
visit parties and fashionable gatherings in order 
to feast their vanity upon the flattery of fools. 
See the numbers who nightly visit places of 
amusement, witness exciting performances, return 
home at midnight, eat heavy, indigestible lunches, 
and perhaps drink wine, and then retire to bed to 
a restless, dreamy, feverish slumber, continued 
well into the next day- 
Prospective mothers often partake of too great 
a variety of highly seasoned and stimulating food. 
Many keep up a morbid excitement of the imagi- 
nation by reading brain-sick novels. Want of a 
sufficient amount of invigorating exercise in the 
open air is a prolific source of ill health in this 
class of women, especially in cities. Living in 
tight, ill-ventilated and often over-heated rooms. 
Inattention to cleanliness and the bath. Among 
the poor, over-work, want of sufficient amount of 
nourishing food, and the cares, troubles and anxi- 
eties of life. And last, but not least, that great 



18 AN ESSAY ON THE 

lever of the physical degeneracy of the race — 
tight lacing. Philanthropists, physicians and 
physiologists have been preaching, lecturing, 
writing and praying for the last fifty years to set 
forth the enormity of this suicidal, matricidal, in- 
fant-destroying sin ; but their warnings fall upon 
the ears of society as sounding brass and a tink- 
ling cymbal, and the practice still continues una- 
bated. Girls, before they have entered their teens, 
must have their waists screwed up in an immov- 
able vise of steel, whalebone and lacings, to sat- 
isfy the imperious demands of a blighting fashion, 
created and sustained by depraved and distorted 
views of the divine beauty of the female form. 
Thus educated from childhood, women grow up 
and depart not from the teaching, but instruct 
their children to do likewise ; and thus the evil 
has been propagated from generation to genera- 
tion, each having to suffer for the sins of previous 
ones as well as its own, until the cumulus upon 
the present one has become as a great, huge mill- 
stone, bearing down and crushing the vitals out 
of the race. No one but the experienced physi- 
cian knows what a vast per cent, of the present 
generation of women is afflicted with some dis- 
ease or weakness originating from this cause, 
which incapacitates them for the healthy perform- 
ance of the maternal function. It is a habit which 
thousands practice without a suspicion of the evils 
it engenders. Very few, indeed, can be induced 
to believe that the maladies they suffer can have 
their origin in a habit apparently so indispensable 



CAUSES OV ENFANT MORTALITY. li> 

to their comfort. It is a habit, like most other 
bad ones, which, when once adopted, can not be 
discontinued without the utmost effort on the part 
of its votaries. It is frequently begun in girlhood 
or early womanhood ; the compression used being 
but slight at first, a feeling of comfort and sup- 
port is experienced, and the carriage and personal 
bearing are improved. Feeling pleased with the 
experiment, it is continued. As time passes the 
bones and muscles of the parts involved become 
enfeebled instead of strengthened by the artificial 
support, and the compression requires to be grad- 
ually increased in order to produce the same feel- 
ing of comfort and support it did at first. In this 
way a degree of compression is finally attained 
which at first the most heroic fortitude could not 
have withstood. Yet it is continued, and deemed 
an indispensable to comfort, while it is squeezing 
the very life out of its victim. This, it will be 
seen, is but a parallel of all other bad habits. 
Like the fabled syrens, it allures to destruction, 
and even the lute of Orpheus has never been able 
to break the spell. The functions of the lungs, 
of the heart, of the stomach, the liver, the bow- 
els, the womb and the mammary glands are all 
encroached upon and their healthy action im- 
^ peded. Hence lung diseases, heart diseases, dys- 
pepsia, liver complaints, bowel derangements and 
womb complaints are all engendered by this un- 
natural fashion. Under its blighting influence, 
beauty, health, grace, cheerfulness and good tem- 
per often become materially impaired before that 



20 AN ESSAY ON THE 

age is attained which fits woman for becoming a 
wife and a mother. Even the lilies fade where 
the roses should bloom, and the painter's art is 
called in to inspire dead beauty with life. 

If the practice of lacing and wearing corsets is 
so perilous to female health at all times, it is but 
reasonable to suppose that it is much more so 
during gestation, and that the unborn infant must 
share the penalties of the sin. Doubtless every 
experienced physician has observed the great 
number of miscarriages, abortions, still-born and 
puny children among mothers who suffer from 
this practice. " The Romans were so well aware 
of the mischief caused by compression of the 
waist during gestation that they enacted a posi- 
tive law against it. Lycurgus, with the same 
view, is said to have ordained a law compelling 
pregnant women to wear very wide and loose 
clothing." It is a well known fact that many 
fashionable ladies continue to wear corsets and 
lacings in order to preserve their wonted personal 
appearance in society until gestation is well ad- 
vanced, loosing them from time to time barely 
sufficient to give breathing room. Such a prac- 
tice imperils the life and future health of the in- 
fant, to say nothing of the consequences to the 
mother. 

It may be deemed indelicate and ungallant to 
refer to these matters in the manner I have done, 
but in summing up the causes of infant mortality 
such a course became unavoidable, as they de- 
serve a prominent consideration, and therefore 



CAUSES OF ENFANT .MORTALITY. 21 

could Dot be passed over in silence. Those who 
desire enlightenment as to the causes of the evils 
befalling the infant population must not shrink 
from the investigation through false modesty. 

My next paper will be on the extrinsic causes 
of infant mortality, or those operating ou the 
child after birth. 



ARTICLE III. 

THE EXTEINSIC CAUSES OF DISEASE. 

Having in my previous article treated of the 
causes of sickness and death among infants aris- 
ing from parentage previous to birth, the little 
stranger, as an independent being, will now make 
his debut and demand our consideration. It will 
be seen, by recalling the facts presented in my 
former papers, that his existence previous to birth 
has been frequently sorely jeopardized by the con- 
stitutional infirmities, accidental misfortunes, or 
cruel wickedness of his parents. Is it surprising, 
considering the many constitutional infirmities 
and wicked violations of the laws of health under 
which the present generation of parents suffer, 
that so many children are born to an inheritance 
of physical and moral depravity, disease and 
death \ Many come into the world as frail as a 
gossamer and are swept into the grave by the gen- 
tlest breath of heaven. Hence it is that between 
one-third and one half of all children born in civ- 

2 



22 AN ESSAY ON THE 

ilized society die in five years. Such lias been the 
case for centuries, or from as remote a date as 
statistical records can be had. It has even been 
much greater in old countries in past times. The 
present infant mortality in our city, of forty 
per cent, under five years, is, therefore, not extra- 
ordinary ,^as all the cities of the civilized world 
present but a trifling variation from these figures. 
But all the sources of weakness and disease 
which beset the young previous to birth, numer- 
ous as we have in our former papers seen them to 
be, are not sufficient to account for so great a 
death-rate amongst them. We must, therefore, 
seek a solution of the problem in the various ex- 
ternal conditions with which infancy is surrounded 
subsequent to birth. These constitute the ex- 
tkwsic or exciting causes of disease. 

The causes of disease which originate with the 
parents and operate on the infant previous to 
birth serve only to diminish its constitutional 
vigor, its vital force, its powers of resistance, 
rather than to implant actual disease in its or- 
gans. Very few children, indeed, are born with 
actual disease existing in them. It may be justly 
said that, with very few exceptions, all children 
are born in a state of health. But the powers 
possessed by different individuals of resisting the 
extrinsic sources of disease and retaining that 
state are just as various as the parental influences 
from which they have derived their origin. Hence, 
if we can preserve even the feeblest infant from 
the action of those causes from which disease 



CAUSES OF INFANT MORTALITY. 2o 

arises, and by judicious management preserve it 
in that state of health in which it is born, the 
chances are that we will succeed in rearing it to 
maturity. A puny stalk of corn sprung from a 
defective seed, if taken as soon as it comes forth, 
may, by judicious culture, care and preservation, 
be reared to maturity and bring forth lusty ears. 
But without this judicious culture it will perish. 
So it is with the puny child. If the treatment it 
receives be in harmony with the laws of its con- 
stitution, the chances are that it will live and 
thrive, and vice versa. 

A vast majority of the diseases which afflict 
and destroy infancy arise from mismanagement. 
This arises chiefly from the ignorance of the man- 
agers, be they parents, nurses, physicians, legis- 
lators or what not ; all are responsible, to a greater 
or less extent, as we shall hereafter see. It is 
granted that a certain per cent, of the mortality 
arises from causes over which man has little or no 
control. These causes I will enumerate, viz. : 

i^Vs£.— Hereditary predisposition. This man 
has no power to control after the child is born. 

Secondly. — Unavoidable accidents. These 
will occur under the most enlightened system of 
management which it is possible to conceive, but 
will be diminished in proportion to the advance 
of knowledge. 

Thirdly. — Those conditions of nature by 

WHICH WE ARE SURROUNDED OVER WHICH MAN 

has no control. Such are the changes of the 
seasons — rain, sunshine, storm, &c. 



24 AN ESSAY ON THE 

From these three sources arises all that per 
cent, of infant mortality over which man has no 
control. Now, let us examine each briefly in de- 
tail, and see if we can come to any conclusions as 
to the amount of death arising from each of them, 
and what per cent, of the whole infant mortality 
arises from the aggregate of them. We must not 
hope for mathematical accuracy, but it is believed 
that a fair approximation to the truth can be ar- 
rived at. 

First, — I believe that the experience of physi- 
cians and the statistical records of mortality will 
justify the conclusion that the number of infant 
deaths arising strictly from hereditary causes, 
without the action of those secondary causes over 
which man holds a controlling influence, is very 
small. It is a fact well known to all that many 
puny children who have inherited a defective con- 
stitution are, by the adoption of a judicious 
physiological system of management, reared to 
maturity and enjoy reasonable health to a good, 
ripe age. ISTow, is it not reasonable to conclude 
that if the same judicious management were ap- 
plied to all cases of the kind, that the death-rate 
arising strictly from hereditary causes would be 
reduced to a very small amount? I believe the 
premises will warrant the conclusion that it would 
not exceed ten per cent, of the entire infant mor- 
tality under five years. 

Secondly. — The per cent, of infant mortality 
arising from unavoidable accidents is small. I 
believe the statistical records of mortality in this 



CAUSES OF tNFANT MORTALITY. 25 

and other countries will justify me in placing it 
at not above five per cent. 

Third! i/. — What per cent, of infant mortality 
arises from the conditions of nature with which 
we are surrounded over which man has no con- 
trol i This is a question not so easily disposed of. 
It involves the whole philosophy of man — the na- 
ture of the human constitution and its relations 
to the external world. 

The most rational system of the philosophy of 
man that has ever been promulgated to the world 
(see Combe on the Constitution of Man) goes far 
to establish the fact that the constitution of man 
is in perfect harmony with the conditions of na- 
ture with which we are surrounded ; that disease 
and premature death arise from violation of that 
harmonious relationship; that if man would ac- 
commodate his conduct to these conditions of na- 
ture — in other words, would live in habitual obe- 
dience to the fixed and immutable laws of the 
Creator, he would live in the uninterrupted enjoy- 
ment of health from birth to old age (provided his 
hereditary predisposition should be favorable), 
and finally die with scarcely a pang or a regret. 
Who will say that the constitution of man is, by 
nature, imperfect ? The same will accuse its Au- 
thor of being a bad workman. Who will say that 
the system of external nature around us, so beau- 
tiful, so varied, so harmonious, so pleasing to the 
senses, so inspiring to the mind, is not in harmony 
with the nature of man, who obviously stands 
pre-eminent among created things in this sublu- 



26 AN ESSAY ON THE 

nary world ? The same will impeach the Creator 
as an imperfect God. No ! the existence of such 
an appalling amount of disease and premature 
death is an evidence that we violate by our own 
conduct the conditions of nature established by 
the Creator, upon which life, health and happiness 
depend. Every law of nature and every object 
with which we are surrounded were doubtless 
designed by the Creator to contribute to the well- 
being and happiness of man, and yet what law 
of nature is not violated and made the source of 
disease and death ? It is by the abuse of those 
things designed by the Creator for our greatest 
happiness that we make ourselves most miserable. 
Man can not change the order of nature. " He 
can not arrest the sun in its course so as to avert 
the wintry storms and cause perpetual spring to 
bloom around him ; but by the proper exercise of 
his intelligence and corporeal energies he is able 
to foresee the approach of bleak skies and rude 
winds, and to rear, to build, to fabricate, and to 
store up provisions ; and by availing himself of 
these resources and accommodating his conduct 
to the course of nature's laws, he is able to smile 
in safety beside the cheerful hearth when the ele- 
ments maintain their fiercest wars abroad." Even 
if man had the power to change the seasons and 
create perpetual spring, who will say that such 
change would be desirable ? It is this harmoni- 
ous evolution of the seasons which furnishes man 
with some of his greatest delights, and prepares 
him for the highest order of his enjoyments. KTa- 



CAUSES OF INFANT MORTALITY. 27 

tore, ever changing, like a grand, moving pano- 
rama before him, never ceases to engage his fancy 
and delight his eye. Variety is beauty, is life ; 
sameness is dullness, insipidity, death. It is in 
those regions of the earth where the greatest 
variety of climate abounds that man attains his 
grandest proportions in intelligence and the arts 
of civilization. The center of civilization is con- 
fined to a narrow zone around the globe, embrac- 
ing in the different seasons of the year almost all 
the climates of the world ; while the inhabitants 
of tropical regions, where perpetual spring 
abounds, are dull, stupid creatures, mere intel- 
lectual automata. It can not be that the Creator, 
after having scattered such a profusion of bless- 
ings on man in the temperate zone, has constituted 
the changes of the seasons a necessary cause of 
disease and death among infants. That the mor- 
tality of infancy is greater during the heats of 
summer and the bleak, cold winds of winter is of 
itself no evidence that hot weather and cold are 
necessarily causes productive of this result ; but 
should rather, in my opinion, be deemed an evi- 
dence that we have failed to discover the true na- 
ture of the relationship existing between the in- 
fant constitution and these seasons, and to regu- 
late our management in harmony with it. 

The subject of atmospheric vicissitudes and 
malarial influences as causes of infant mortality 
may be deemed appropriate for consideration 
here. But, as many of the observations I have made 
in reference to the changes of the seasons will 



28 AN ESSAY ON THE 

likewise apply to that of atmospheric vicissitudes, 
I shall, therefore, dismiss it, lest I become tedious. 
As for malarial influences, they generally arise 
from local causes over which man holds an entire 
controlling power; the subject may, therefore, 
be more appropriately discussed elsewhere. 

The various diseases of children arising from 
contagion^ namely : measles, small pox, whoop- 
ing cough, scarlet fever, &c, are supposed to de- 
pend on influences over which man has but a par- 
tial control. However, vaccination being almost 
a specific for small-pox, very few children should 
perish from it if due diligence be practiced. 

Conceding that the changes of the elements and 
other natural influences over which man has no 
control will necessarily produce a share of the 
infant mortality, what per cent, of the death-rate 
shall be accounted to these causes ? After a due 
consideration of the facts and inferences, based 
on statistics (which I have no room here to intro- 
duce), I have deemed twenty per cent, a fair and 
liberal estimate. 

It will now be seen that I have accounted for 
but thirty-five per cent, of the present mortality 
of children under five years. Whence originates 
the remaining sixty -five per cent. ? It is my hon- 
est conviction, formed from a long and careful 
study of the subject, that sixty -five out of every 
hundred, or nearly two-thirds of all children that 
die under five years, perish as a consequence of 
mismanagement, arising chiefly from ignorance of 
the known laws of physiology and hygiene. The 



CAUSES OF INFANT MORTALITY. 29 

question at once arises, who are so ignorant, and 
from whose mismanagement arises so appalling a 
result? 

My next article will be devoted to answering 
this question, when I shall proceed with the in- 
vestigation "without fear or favor or hope of re- 
ward," save the pleasure it gives me in being able 
to contribute to the dissemination of what I be- 
lieve to be useful knowledge. 

P. S. I have heard of some criticisms on my 
previous articles from members of the profession, 
to the effect that, the facts and conclusions are 
very true, but that the public should not be en- 
lightened on these subjects ; that such knowledge 
should be kept among the profession. I believe 
all good people will join me in the conviction that 
any physician who entertains such a sentiment as 
this is either so ignorant as to deserve pity or a 
dangerous enemy to the best interests of society. 
But I can not believe that many of them entertain 
so degrading a sentiment. 



ARTICLE IV. 

CAUSES OF INFANT MOKTALITY AEISING FROM THE 
MISMANAGEMENT OF PAEENTS AND NUESES. 

The conclusion was formed in my last article 
that but thirty-five children out of every hundred 
that die under five years perish from natural 
causes over which man has little or no control, 



30 AX ESSAY ON THE 

and that the remaining sixty-five die from mis- 
management, arising cMefly from ignorance of 
the ~known laws of physiology and hygiene. 

The responsibility for this mismanagement rests 
on society in general, but, for the sake of conve- 
nience in discussing the subject, the responsible 
parties may be divided into three classes, viz. : 

First. — Parents and nurses. 

Secondly. — Legislators, or those whose duty it 
is to make and execute sanitary laws. 
Thirdly. — Physicians. 

When I shall have discussed each of these 
classes my essay will end. 

First. — The chief sources of infant mortality 
arise from the mismanagement of parents, and 
others under their control, viz. : nurses. 

It must be obvious to every thinking mind that 
our chief hope of greatly reducing the present in- 
fant mortality lies in preventing the diseases in- 
stead of curing them ; because, considering the 
many infirmities of constitution which children of 
the present generation derive from their parents, 
many of the diseases which afflict them will neces- 
sarily prove fatal, despite all the remedial influ- 
ences of medicine, potent as they are. And it is 
also obvious that the prevention of sickness 
amongst children must necessarily be the work of 
parents, as such, more than all other parties put 
together. Unless the management of the parents 
be judicious many diseases will arise and often 
prove fatal, even with the best sanitary regula- 



CAUSES OF INFANT MORTALITY. 31 

tions on the part of public authorities and the 
most skillful treatment by physicians. 

It has ever been the characteristic of ignorance 
and its twin sister, superstition, to attribute every 
phenomenon in nature, the cause of which can 
not be obviously seen, to the dispensations of 
Providence. This view has had its influence on 
society to such an extent in former ages as to in- 
duce the almost universal belief that sickness and 
health, prosperity and adversity, are dispensed 
out to each individual by Providence as the 
butcher dispenses meats to his customers, giving 
this one a good piece and that one a bad one, ac- 
cording to his own whim or caprice, and without 
any law or rule within the province of human in- 
telligence to comprehend except the one by which 
the butcher is governed — that is, the amount of 
reward, the butcher taking his in dollars and 
cents while Providence should be paid in a differ- 
ent way. I say this has been the philosophy of 
the past. But, by the diffusion of intelligence 
and the advancement of science, much of this an- 
tiquated superstition has been dispelled, and more 
rational views of the nature of God's government 
of the world are gradually taking possession of 
the human mind in the more civilized and enlight- 
ened parts of the earth. As the light of science 
shines in upon the human mind it opens up 
grander views of the Divine government — views 
which inspire us with delight, wonder, awe and 
reverence. The great truth becomes conspicu- 
ously recognized, that all nature is governed by 



AN ESSAY ON THE 



fixed and unchangeable laws, and that health and 
disease arise from obedience and disobedience to 
these natural institutions. Hence the great truth 
should ever be present to the mind of all, that 
when a child gets sick (except in those cases aris- 
ing from natural causes, already spoken of), its 
keepers are responsible for having violated the 
conditions of its nature, upon which alone the 
Creator insures its health and safety. In other 
words, that a child is sick (except in the cases as 
above) is of itself prima facie evidence that it has 
been mismanaged, either by its parents, the pub- 
lic sanitary authorities, or whoever may be its 
keepers. 

The natural laws governing the functions of the 
animal body are called the organic laws, or the 
physiological laws, or are more familiarly known 
as the laws of Tiealtli. To descend into particu- 
lars and show how parents violate these laws in 
the management of their children would be a 
hopeless task in an article like this. The utmost 
that I can do is to point out a few of the laws and 
give some striking examples of their infringement. 

First, may be mentioned the dietetic laws — 
those which relate to food and diet, under which 
head may be discussed everything that enters into 
the stomach. How many children are made sick 
unto death by violation of the dietetic laws? 
Mothers often begin these violations with the na- 
tal hour of their children. Ignorantly bidding 
defiance to the suggestions of nature, that the 
bland, watery fluid secreted in the mother's breast 



CAUSES OF INFANT MORTALITY. 33 

is the only substance that should enter the infant 
stomach, they cram it with paps, panadas, sugar, 
teats, candies, fruits, tea and coifee, sweetmeats, 
and a thousand other things, some of them very 
disgusting. Besides, a good assortment of wines, 
brandies, whiskys, soothing syrups, cordials- 
drops, potions, &c, is kept on hand for adminis- 
tration in case the little stomach should rebel 
against the heterogeneous incompatibles so wick- 
edly thrust into it. I do not say that any 
mother gives all the articles I have indicated ; 
but different mothers use different ones, as 
guests do different dishes at a hotel. I was 
recently called to see a woman in confinement. 
When I arrived the child was born and all 
were doing well. When I went to the bedside to 
salute the little stranger what was my amazement 
on finding it with a huge slug of old, fat, raw ba- 
con in its mouth ! I at once relieved it of the dis- 
gusting morsel, and reprimanded the mother for 
her ignorant conspiracy against the life of her in- 
nocent babe. She answered by saying u she 
thought it was right, because her mother had al- 
ways served her children so." I told her that if it 
had been right, nature would have so arranged it 
that all children would have been born with a piece 
of bacon in their mouths. I gave orders that 
nothing but the mother's milk should be given it, 
but what was my surprise on returning two hours 
after to find the nurse feeding it on brandy toddy ! 
She said " it cried as though it had the colic, and 
she had given it a dose of soothing syrup, but 



34 AN ESSAY ON THE 

that did not relieve it, so she thought she must 
keep doing something." Think of it ! an infant 
not six hours old had its maiden appetite spoiled 
by a slug of raw, fat bacon, and having failed to 
digest it, a dose of soothing syrup and a horn of 
brandy toddy were administered, and all with the 
very best intentions on the part of parent and 
nurse ! The child barely escaped with its life ; 
had it died it would have been regarded as a " mys- 
terious dispensation of Providence." This is not 
an uncommon case ; thousands such occur. Every 
experienced physician has doubtless seen numbers 
of similar ones. Nor are they confined to what 
is called the ignorant class of society. 

A large majority of all the bowel complaints 
that afflict and destroy infancy result from viola- 
tions of the dietetic laws. A child, feeble from 
inheritance and from the action of bad influences 
with which it may be surrounded, may be de- 
stroyed by a single impropriety. A bit of bread 
crust, a sweet cake, a nut, anything, improperly 
given may turn its feebleness into an actual dis- 
ease which will defy all the skill of physicians 
and send its victim to the grave. It is from these 
apparently trivial things that many of the most 
fatal diseases arise. Like little trickling streams 
that issue from a thousand mountain sides in the 
wilderness, perhaps so small where they issue 
forth that a finger's end will stop the flowing 
veins, but as they murmur along their meander- 
ing way they unite, they gather strength from 
every hand, until they become a roaring torrent 



CAUSES OF INFANT MORTALITY. 35 

that defies every obstacle and sweeps everything 
before it in its onward course to the sea! So it is 
with little improprieties, little violations arising 
in the wilderness of ignorance, apparently trivial 
at first, they accumulate and gather strength as 
they pass on until they finally break out into a 
vast river of disease which bids defiance to all 
human power to control, as it rolls its onward way 
and sweeps every victim before it into the great 
ocean of death ! 

Secondly. — Violations of the respiratory laws 
are, perhaps, almost as frequent and fatal amongst 
children as those just considered. The respiratory 
laws are those governing the function of respira- 
tion or breathing. Under this head may be con- 
sidered all the diseases arising from breathing an 
impure air. Most persons have a vague idea that 
it is unhealthy, especially for children, to breathe 
an impure air ; but very few know anything more 
about the matter than this. What constitutes 
pure air and the purposes it subserves in sustain- 
ing life, and also what constitutes foul or impure 
air and the sources which give rise to this and the 
evils it engenders to health, the vast majority of 
the people are about as ignorant of as the man 
in the moon. I was recently called in haste to see 
an infant that had been born but an hour. The 
messenger informed me that it appeared very ill. 
On my arrival, although I had but a short dis- 
tance to go, it was dead. It was full grown and 
to all appearance had been healthy. But the pro- 
bable cause of its sudden decease was very evi- 



36 AN ESSAY ON THE 

dent on entering the room, which was small, all 
the doors and windows tightly closed, except a 
door leading into an adjoining room where the 
cook was preparing "breakfast. The steam of hot 
meats and other victuals pervaded the rooms. In 
the lying-in room were three persons , and in the 
kitchen three children and the cook. The air, be- 
sides being stagnant from confinement, was so 
vitiated by the breath of the inmates and the ex- 
halations from their bodies and the cook stove, 
that the infant perished in an hour ! The parents 
wept over their child and marveled at the " mys- 
terious dispensations of Providence." 

I can not enumerate the sources of impure air ; 
it would require a long chapter. It must suffice 
to say that tenfold more sources of vitiation arise 
inside of people's houses and rooms than ever 
enter through the doors and windows from abroad. 
The opprobrium of city life is " foul air ; " but in 
my opinion it arises more from foul habits and 
foul rooms than any external source of vitiation. 
Many people are afraid to expose their children to 
the external air, as though it were their worst 
enemy. The fact is, they keep them in the house 
so much that when they are taken out, without 
great care, they take cold; just like one who has 
been starved for a great length of time will make 
himself sick by eating when furnished a sumptu- 
ous meal. Children thus kept in doors, in rooms 
frequently over-heated and filled with a stagnant, 
impure air, grow up, if they live at all, pale and 
sickly, like weeds grown in a dark cellar. They 



i AUSES OF INFANT MORTALITY. 37 

resemble the seeds, in the famous parable, that 
fell on stony ground; they soon sprang up, but, 
not having much root, as soon as the hot sun came 
they withered and died. 

Too many mothers trust their children to nurses 
much more ignorant and careless than themselves. 
Many fashionable ladies are too delicate, too nice, 
now-a-days to have anything further to do with a 
child after it gets old enough to cry except to send 
for it occasionally to make an exhibition in the 
parlor to some dear friend. I observed a few days 
ago two little babies — ruby-lipped little jewels 
they were, too — sitting on the cold, stone steps of 
a church near my office, where they had been 
placed by their nurses — two " colored ladies " — 
who sat near by, quietly discussing their own 
affairs. They sat, I should think, near half an hour, 
for they were too young to crawl about. The day 
was tine over head, but all know how cold stone 
steps are in early spring, and how soon the cold 
will penetrate through several garments by sitting 
on them. No doubt the mothers had sent out the 
children into the air for their health, a thing en- 
tirely right in itself, but wrong only because they 
trusted them in such unsafe hands. If the child- 
ren did not catch their death from the exposure it 
was not for want of a good opportunity. But this 
is only a single example ; multitudes of similar 
ones occur continually, and keep the doctors, 
druggists and undertakers employed. 

Woman ought to be educated in physiology 
and hygiene, as a part of her scholastic course. 

3 



38 AN ESSAY ON THE 

Upon the mother especially devolve the duties of 
rearing the young. While the father is away, 
toiling for the means of support for the little ones, 
the mother is at home ministering to their wants. 
The mother leans upon the father for support, and 
the children upon the mother. To bear and rear 
a child aright is the most glorious work that ever 
fell to the lot of mortal in this mundane sphere ; 
and what should woman be educated for if not for 
this great duty ? How can she rear a child aright 
without any just conceptions of the nature and re- 
quirements of the infant constitution, as taught 
by physiology and confirmed by enlightened ex- 
perience ? It is true that mothers may learn much 
by experience ; but all will concede that experi- 
ence is a dear teacher. 

Home is the sphere of woman. Every element 
of her being proclaims her sacred to the precincts 
of home. Her modesty, her domestic disposition, 
her more delicate and polished physical structure, 
her insatiable love of offspring, all declare with 
the everlasting voice of nature that she is the tu- 
telar deity of the household. Nor are her duties 
less important to the interests of mankind because 
thus confined to the family sphere. The home 
fireside is the great school-house of all nations. 
Upon the hearth-stone rests not only the religion, 
the morals and social order of every people, but 
likewise the pillar of State. If we would have a 
religious people, the nurselings must imbibe the 
holy principles of religion from the bosoms of 
their mothers. If we would have a virtuous, a 



CAUSES OF INFANT MORTALITY. :}!> 

moral, a courageous, a temperate people, the 
seeds of these precious qualities must be sown in 
the cradle and by the hearth-stone. ' If we would 
have a just government, administered by just, 
wise and good men, such men must be raised by 
mothers who are capable and willing to give their 
whole mind and soul to the glorious work. A 
mother, by virtue of the sacred function which 
makes her such, is God's vicegerent on earth, 
charged with the nurturing, rearing and develop- 
ing a human being for life, for usefulness, for hap- 
piness, for eternity. She who underestimates the 
sacredness of her calling, as such, or proves re- 
creant to its holy duties, is, to say the least of it, 
something less than a woman should be. She who 
imagines that there is a higher, more noble and 
useful sphere for woman than the family fireside, 
is lost to a true conception of the good, the right, 
the noble and the true. 

My space is full. 

My next article will be on the sources of infant 
mortality arising from such causes as should come 
within the province of public sanitary authorities. 



40 AN ESSAY ON THE 

ARTICLE V. 

INFANT MOETALITY ARISING FROM SUCH SOURCES 
AS SHOULD COME WITHIN THE PROVINCE OF THE 
PUBLIC AUTHORITIES. 

This article will be devoted to the consideration 
of snch sources of disease among children as 
should come within the province of the public 
authorities. 

The reader should constantly bear in mind that 
all the causes of feeblness and disease which I 
have hitherto enumerated may, and often do, 
operate in conjunction ; that is to say, a child 
may be 'feeble by inheritance, it may have its 
vitality further impaired by improprieties of the 
mother during carriage, and by mismanagement 
after birth. With all these causes of enervation 
operating on it the slightest exciting cause may 
bring on an active disease, although it may ap- 
pear in good health and may never have had an 
hour's sickness in its life. A little impropriety 
in diet, a change in the weather, a few hot, dry 
days, breathing an atmosphere made foul by 
some local cause in the neighborhood, and many 
other causes acting singly or in conjunction, may 
serve to excite an attack of cholera infantum, 
convulsions, or some other terrible and fatal dis- 
ease, any and all of which causes may have no 
effect on a child that has been more favored in 
constitutional vigor and previous treatment. It 
is my opinion that one of the chief causes of 
cholera infantum in our cities during the summer 



CAUSES OF INFANT MORTALITY. 41 

months originates in the bad management of 
children during the winter. This bad manage- 
ment consists in keeping them too much confined 
in ill- ventilated, often over-heated, and frequently- 
foul rooms. By this treatment they become so 
enervated that the heats of summer destroy them 
by this terrible disease. That it is not the action 
of solar heat alone that produces this disease is 
evidenced by the fact that it is actually less pre- 
valent in the South than in the North. There is 
actually less mortality from cholera infantum in 
the cities of Charleston and New Orleans than in 
New York, Philadelphia and St. Louis — the win- 
ters being so mild in the South that children are 
not kept confined in doors so constantly, nor for 
so great a length of time, as they are during the 
winters at the North. Therefore they are able, 
in the former situation, to withstand even a greater 
heat with less mortality from this disease. This 
is a theory which I have not seen before advanced, 
but I believe it will furnish a key to the cause of 
so much cholera infantum amongst us. 

I believe it will be conceded by those who have 
carefully read my previous articles that I have 
already sufficiently accounted for the great pre- 
valence of infant mortality; nevertheless there 
are other causes to be considered, which, although 
they may be insufficient of themselves, with per- 
haps a few exceptions, to excite fatal diseases 
among children, do nevertheless, by operating in 
conjunction with others, no doubt prove the source 
of much fatality. 



42 AN ESSAY ON THE 

The chief sources of infant disease which come 
within the province of public authorities consist 
in aberrations of the atmosphere from a healthy 
standard, arising from local causes. This ques- 
tion involves the consideration of malarial influ- 
ences arising from marshy soils, healthy and 
unhealthy sites for residences, towns, cities, etc, 
all of which can not be considered in so short an 
article. I will, therefore, confine my observations 
to the consideration of bad air in cities ; and even 
this can be but brief. 

The chief sources of impure air in cities are an- 
imal and vegetable substances in a state of de- 
composition, and the unhealthy qualities which 
the air acquires by its stagnation in confined 
places. All organic substances, that is, every- 
thing of animal and vegetable origin, as soon as 
life is extinct, begin to decay, to decompose, to 
pass back again into their original simple ele- 
ments from which the life power drew them by 
its organizing force. During this process of de- 
cay many substances become volatilized and 
float about in the air as gases. These gases, 
when breathed or absorbed by the skin, become 
detrimental to health in various ways, depending 
on their quality and quantity. They may disturb 
the healthy equilibrium of the air, either by 
diminishing its free oxygen, by forming new com- 
pounds with some of its elements, or by simply 
mingling with it a foreign substance. Heat and 
moisture hasten the processes of decomposition 
and volatilization; hence it is that the air in 



CAUSES OF INFANT MORTALITY. 18 

cities ia much less pure in summer than in winter. 

The poisonous qualities of decaying substances 
can not be measured by the amount of odor they 
emit. The vulgar notion prevails that a decay- 
ing substance can not be detrimental unless it 
stinks ! It should be borne in mind that the most 
deadly atmospheric poisons produce no percepti- 
ble impression on the senses. Their presence is 
known only by their toxical action on the system. 
In fact, those substances that emit an odor give 
off their particles in so gross a form that they 
seem to deteriorate the air, either by simply dilut- 
ing it, so that the same volume contains less life- 
sustaining element, or by uniting with its oxygen, 
and thus generating carbonic acid and other 
detrimental compounds ; while more deadly mias- 
mas and contagions are so attenuated as to pervade 
the air without disturbing its elements, as elec- 
tricity pervades gross matter. 

The way to keep a city healthy is to keep it 
clean ! It is not enough to keep the streets clean ; 
they are generally kept sufficiently so for all san- 
itary purposes in most cities. It is in the narrow 
alleys, the open courts in the midst of squares, 
the dark, damp corners and unmentionable places 
that pestilence is born and bred; and it comes 
through the back windows, like a thief at night. 
People will grumble if the public authorities leave 
a little filth in the streets, lest it breed an 
unwholesome air, while the rear of their own 
premises is so foul that no amount of charity can 
plead an extenuation of their culpability. The 



44 AN ESSAY ON THE 

air in the street is always moving, and as fast as 
effluvium is given off it is driven away by the 
winds. The most gentle breeze travels four or 
five miles an hour, while a lively gale goes from 
twenty to fifty in that time, and storms an hun- 
dred. People even murmur at the rudeness of the 
winds, whereas, without their purifying influence 
the inhabitants of densely populated cities would 
soon all perish, as the result of accumulations in 
the air. 

There are many sources of foul air in cities 
which it would be tedious to mention, the most of 
which might be removed. St. Louis has her stock- 
yards and slaughter-houses inside the city limits, 
a thing which should not be permitted for the 
best of reasons. 

There are some kinds of manufacturing estab- 
lishments especially noxious to the health of the 
neighborhoods in which they are situated ; among 
such may be mentioned soap factories, tanneries, 
tallow chandleries, etc., and others which emit 
smoke, dust and various kinds of effluvia. 

We often observe slop-carts and garbage wagons 
passing along the streets, emiting such a foul odor 
that no language can describe it. Sometimes, 
when the air is still, in warm weather, the pestilen- 
tial stench of the cart or wagon and its contents 
will remain for a considerable time in the track, 
contaminating the air and sowing the seeds of 
pestilence. 

Vaults and water-closets, not properly drained 
by sewerage, is a frequent source of pestilential air. 



CAUSES OF INFANT MORTALITY. 45 

In cities many of the poor live in old, damp, 
decaying buildings, in narrow alleys]and in court- 
yards infested with vermin, rats, etc., and sur- 
rounded by high, walls on every side, which 
exclude the sunlight and free air all the year 
round. Such places, too, are often the most re- 
mote from drainage and sewers. Filth accumu- 
lates upon filth until the very souls and bodies of 
such inhabitants become literally made up of the 
vile stuff in which they perpetually live. Such 
lazy, indolent people breed like spawning fishes, 
until each household is alive with breathing pau- 
pers. In many places cats, dogs, pigs, goats, etc., 
in great numbers, are denizened upon terms of 
perfect social equality with the viler biped inhab- 
itants. 

Is it a wonder that infants die in such places ? 
The greater wonder is that any of them live. It 
is as much the duty of the public sanitary author- 
ities of cities to remove and prohibit such nui- 
sances as it is to remove the carcasses of dead 
animals, dunghills, etc., from the streets. 

Air soon becomes unhealthy by stagnation, 
even as water does. Hence the great impropriety 
of open courts in back yards, surrounded by high 
walls, with no sufficient openings for the winds to 
drive through. Such places, although they may 
be enclosed in gold and silver, and kept perfectly 
clean, will soon become unhealthy from stagnant 
air ; and, of course, they become more pestilential 
in proportion to the amount of filth they contain. 

Children kept in doors during the winter, in 



46 AN ESSAY ON THE 

dark, over-heated, ill-ventilated rooms, die by the 
heats of summer. The same thing is exemplified 
in many vegetables, which, if generated in warm, 
moist places, excluded from the light, will perish 
as soon as they are exposed to the light and heat 
of the sun, unless great care be taken to make the 
transition gradual. To obviate this effect of the 
summer heats on such children it seems desirable 
to modify, as much as possible, the still, dry heats 
of the summer months. There are but three ways, 
that I know of, to accomplish this end on a large 
scale, viz. : 

First. — By making the streets wider. 

Secondly. — By the judicious culture of trees 
and shrubs. 

Thirdly. — By providing little streams of run- 
ning water in every street. 

AH our streets are too narrow. They ought to 
be at least double their present width ; and every 
one, or at least every alternate one, should have 
a little inclosed park, say thirty or forty feet 
wide, in its midst, adorned with trees and shrub- 
bery. Tourtelle, a celebrated French physiolo- 
gist, says : " The trees attract the clouds, retain 
their moisture in their leaves and branches, and 
are so many ventilators, which agitate and cool 
the atmosphere." They do more, they absorb 
carbonic acid and give off oxygen. It is not prob- 
able the cities of the present will be remodeled so 
as to make the streets wide enough for sanitary 
requirements, but future cities, built by men more 
enlightened in the philosophy of man and his re- 



CAUSES OF INFANT MORTALITY. 47 

lations to external nature, will doubtless be con- 
structed more in harmony with these requirements. 
The increased facilities of locomotion which mod- 
ern times have brought into use have obviated 
the necessity of huddling vast hordes of people in 
so close proximity for the sake of mere conveni- 
ence. When a man can eat his breakfast at 
home, five or six miles out, jump into a car and 
be landed at his shop door in a very few minutes 
at a trifling expense, it is vastly better for him 
and society than for him to live in a narrow 
street, surrounded by high walls and hordes of 
human beings. Nay, society ought to compel 
him to do so for sanitary reasons, if he is not able 
to occupy comfortable and healthy quarters in a 
more central position. 

The evaporation from streams of running water 
in the streets would do much to mitigate the ex- 
cessive heat of dry summer weather. "While 
moisture from decaying animal and vegetable 
matter is detrimental to health, the vapor arising 
from streams of running water is very beneficial 
in dry, hot weather. Besides cooling the air, it 
does much to restore and preserve the normal 
amount of its oxygen, which is its life- sustaining 
element. The heat is generally more oppressive 
during the first part of the night. This is due, in 
a great measure, to the fact that during the day 
the sun's rays are absorbed by the walls and 
pavements, and are given off — radiated — at night, 
so that it is often near morning before they become 
cooled down sufficiently to allow the air to assume 



48 AN ESSAY ON THE 

an agreeable temperature. With our present nar- 
row streets, the heat radiated from the walls of 
one side strikes the other side and serves to keep 
up the oppressive warmth. The evaporation from 
streams of water would not only prevent so large 
an amount of heat from being absorbed during the 
day, but would greatly modify the radiation at 
night. A row of trees in the street would like- 
wise moderate the heat by preventing the radia- 
tions from one side passing to the other. But 
trees, like every other good thing, may be abused, 
and made the source of much mischief. When- 
ever they become so numerous and thickly set as 
to prevent the free circulation of air and the ad- 
mission of sunlight, they become detrimental to 
health. 

My next article will treat of the causes of infant 
mortality originating in the mismanagement of 
physicians, and will be the closing one of my essay. 

P. S. — I still hear of mutterings in the profes- 
sional elements about the propriety of my articles. 
The motives which actuate medical men to make 
such remarks I leave for the public to judge. 
Some say that " He who can write such must have 
little else to do." Who wrote your text books, 
Mr. M. D., from which you have derived all your 
learning ? Was it he who had " little else to do," 
or was it he who had dived deep into the great 
arcana of nature and gathered lore from every 
land ? If it was the former, your books are worth- 
less, and all your learning is " as the baseless 
fabric of a vision." 



CAUSES OF INFANT MORTALITY. 49 

ARTICLE VI. 

INFANT MORTALITY ARISING FROM THE MISMAN- 
AGEMENT OF PHYSICIANS. 

The subject of this article is the causes of in- 
fant mortality originating in the mismanagement 
of physicians. 

The physician occupies a peculiarly responsible 
position in society; one that is not well under- 
stood nor appreciated. The patient sins against 
nature by disobeying the organic laws — those 
laws established by the Creator for the regulation 
and government of his physical existence. After 
the sin has been committed, and the patient feels 
the infliction of the penalty — that is, the dis- 
ease — coming on him, the physician is sent for to 
reprieve him from the punishment. The physician 
thus becomes the mediator between the sinner and 
the law, and offers as a propitiation for the sins 
of his patient the means which bounteous Heaven 
has so munificently bestowed for the purpose, in 
the shape of remedies. Hence the true physician 
is the servant of the Divine Master, interpreting 
his will in the great book of nature before us, 
and dispensing out his blessings to many an un- 
worthy sinner. But, in the case of the child, the 
parents are morally responsible for the sins com- 
mitted against nature's laws, although the penal- 
ties fall upon it alone. The physician, in thus 
assuming the functions of an interpreter of nature 
and a dispenser of her blessings, often takes in 
his hands the reins of life and death, and should 



50 AX ESSAY ON THE 

feel the high order of the responsibilities resting 
upon him. 

From the extreme susceptibility of the infant 
constitution to the action of both disease and 
medicine, the responsibility of the physician is 
much greater in treating this class of patients 
than it is in the treatment of adults. The 
life-power of the infant, compared to that of the 
adult, is as a candle to a blazing furnace. The 
one may be blown out by a blast which would 
but serve to increase the other's heat. Hence the 
necessity of treating these little beings with the 
greatest circumspection and the mildest and gen- 
tlest medicines. The physician may fire away at 
his adult patient with all' the artillery of the 
apothecary shop, day after day, and week after 
week, and nature will finally come out victorious 
and restore the patient in spite of the disease and 
the treatment, and the physician will get all the 
glory of the victory. A little anecdote will illus- 
trate the practice of some physicians admirably. 
Two men were riding together along the road, one 
a little in advance of the other ; the foremost man 
rode under a swinging limb of a tree ; as he did 
so, he caught it and pulled it after him as far as 
he could, then letting it go, it flew back and 
knocked the hindmost man from his horse. He 
got up, badly hurt, thanked his companion, and 
told him that if he had not held that limb as long 
as he did it would have killed him. Just so do 
many physicians get the credit of saving their 
patient's lives by almost killing them. However 



CAUSES OF ENFANT MORTALITY. 51 

much undeserved reputation physicians may gain 
by such practice among adults, it proves a blight- 
ing ruin to little children. Even those it does not 
send to the grave, often have implanted in their 
very vitals the seeds of some lasting infirmity. I 
have no disposition to attack any system of medi- 
cine. There is much that is good in all systems, 
and many good, noble and successful practitioners 
of them all. But it is the evils, the abuses, that I 
am striking at, and the results of those evils to the 
infant population. 

The evils which are prevalent in the predomi- 
nant systems of medicine may be discussed under 
three heads, viz. : 

First. — Heroic medication, that is, the use of 
too much powerful medicine. 

Secondly. — The use of such drugs as produce 
lasting infirmities of constitution. 

Thirdly. — The use of drugs in so infinitely 
small doses that reason and enlightened experi- 
ence condemn as entirely wortJiless. 

The first two are peculiar to many practitioners 
of what is known as the " regular practice," and 
the last one to some of the disciples of Hahne- 
mann. 

First. — Heroic medication. Hahnemannism 
(homeopathy) would have died in its chrysalis 
state if it had not been for the wide-spread abuses 
of the prevailing practice. People were sick and 
tired of the practice that bled, salivated and blis- 
tered its victims into the grave, and eagerly caught 
at anything that offered the slightest shadow of a 



52 AN ESSAY ON THE 

hope of delivering them from so murderous a 
practice. An hundred years ago everybody so 
unfortunate as to require the services of a phy- 
sician was bled, mercurialized and blistered, from 
the infant in the cradle to the gray-haired sire by 
his coffin. Thus seas of blood were shed, and 
legions of human beings found a resting place in 
a premature grave as a consequence. Yet the 
doctors believed, in all sincerity and truth, that 
they were doing the very utmost that human 
efforts could accomplish to save their patients. 
Taking every sequence as a consequence, they be- 
lieved that every patient that recovered had been 
saved by the treatment ; and good and pious men 
prayed God to bestow his blessings on their efforts 
while they were unconsciously destroying their 
patients ! In this dark hour homeopathy was born, 
and it was hailed by the people as the weary 
traveler hails the flickering of a lamp in a cottage 
by the wayside when he has lost his way in the 
darkness of the night. It was the greatest nega- 
tive blessing that ever dawned upon humanity 
from the empire of medicine. It was as the watch- 
man's lamp, it threw light upon what men were 
doing in the dark. It soon demoustrated the fact 
that a greater number of the sick would recover 
with no medicine at all (the homeopath's being 
equal to none) than did under the prevailing prac- 
tice. But the people and the doctors who embraced 
the new practice attributed all the good results to 
the infinitesimal medicine, whereas Dame Nature 
should have had all the credit. Although the rise 



CAUSES OF INFANT MORTALITY. 53 

and progress of the homeopathic and eclectic 
systems of medicine have driven the lancet and 
many other implements of torture out of use, 
yet the dregs of the old theories still blubber 
in the bottom of the professional pot. The stick- 
lers of these theories treat diseases as though 
they were killing snakes. A celebrated wit, 
D'Alembert, hits them by the following apologue : 
" Nature is fighting with a disease ; a blind man 
armed with a club, that is, a physician, comes to 
settle the difference. He first tries to make peace ; 
when he can not accomplish this he lifts his club 
and strikes at random. If he strikes the disease, 
he kills the disease ; if he strikes nature, he kills 
nature." Verily, such practice is not uncommon 
amongst us, even in the treatment of tender 
infants. 

Secondly. — It is a well established fact that 
much mischief is done to children by giving them 
mineral poisons. If they do not prove the source 
of fatality at once, they often lay the foundation 
of lasting and incurable ills, by impairing the 
vital powers. They are doubtless often resorted 
to when, if they do not prove positively detri- 
mental, other more efficient remedies might be 
used that would often save life. Calomel, calomel, 
calomel, is the drug constantly resorted to by 
some physicians, in every ailment, from the slight- 
est ill to the gravest malady. Such physicians 
may be, and doubtless are, entirely conscientious ; 
but their judgment and education are, in my 
opinion, sadly at fault. No drug known to the 

4 



54 AN ESSAY ON THE 

human family has ever laid the foundation for so 
much debility of constitution, aches and pains, 
rotten teeth and pestilential breath as this. It is 
one of those drugs that wears on the axles of life, 
as sand on the gudgeons of a machine. The cal- 
omel doctor is the worst enemy to the future 
health of your family that ever set foot upon 
your threshold. The celebrated late Professor 
Nathaniel Chapman, M. D., of Philadelphia, says : 
" He who resigns the fate of his patients to calo- 
mel is* a vile enemy to the sick, and if he has a 
tolerable 'practice, will, in a single season, lay the 
foundation for a good business for life; for he 
will ever afterward have enough to do to stop the 
mercurial breaches in the constitutions of his 
dilapidated patients. He has thrown himself in 
close contact with death, and will have to fight 
him at arm's length so long as one of his patients 
maintains a miserable existence" 

Opium is a dangerous drug for infants. A half 
grain of Dover's powder, containing but a twen- 
tieth of a grain of opium, has been known to 
throw an infant into convulsions. Prof. Christi- 
son says that less than three drops of laudanum 
have proved fatal to stout, healthy infants. Some 
physicians prescribe this drug for infants with too 
reckless a hand. The practice so prevalent among 
mothers and nurses of giving laudanum, pare- 
goric, soothing syrup, &c, is doubtless fraught 
with a fearful amount of death. The cause of 
humanity demands that these evils shall be abated. 

Thirdly. — The administration of medicines in 



CAUSES OF INFANT MORTALITY. 55 

so infinitely small doses as to produce no effect is 
a negative evil rather than a positive one. It, 
doubtless, proves the source of much fatality by 
allowing diseases to go on to a fatal termination 
that might be cured by remedies used in a more 
rational way. But radical homeopathy, that is, 
high dilutions and attenuations, is rapidly declin- 
ing before the advance of rationalism ; and many 
practitioners of that school are now using medi- 
cines in sensible doses ; and some of the most 
successful physicians, especially in diseases of 
children, are among that class. Many home- 
opathic physicians are blatant on every avail- 
able occasion in their abuses of the physicians of 
every other system of practice, because, as they 
allege, all but homeopaths give medicines in such 
ruinously large doses. So thoroughly have they 
succeeded in inflaming the prejudices of some 
weak-minded people in favor of their infinitesi- 
mals that many thus led astray are ready to go 
into tremors at the sight of an ordinary pill, 
although it may be made of the crumbs of bread 
left at their last meal; or to fall into a fit of 
spleen when a labeled vial of colored liquid is 
prepared for them, even though it may be of the 
same bottle of wine from which they regaled 
themselves at dinner. What motives are these 
homeopaths actuated by in thus belaboring them- 
selves continually to frighten the ignorant, and 
propagate prejudice against the sanitary and 
rational use of medicines ? It can not be philan- 
thropy ; for this is made of a different stuff. It 



56 AN ESSAY ON THE 

can not be a zeal for the advancement of science 
and the promotion of truth, for these ends are not 
accomplished by such means. No; the whole 
secret lies in this — their bread depends upon it. 
Without such continued agitation of the subject, 
without such a course of carefully nursing the 
public prejudice, "to keep it warm," the practice 
could not sustain itself, nor its practioners suc- 
ceed in making a livelihood by it. Different 
motives must actuate men who are engaged in the 
cause of science and the discovery and develop- 
ment of truth, and their application to the relief 
of human suffering, the advancement of civil- 
ization and the promotion of happiness. 

I have before observed that the only hope of 
greatly reducing infant mortality lies in pre- 
venting the diseases instead of curing them. 
Physicians can and do achieve much, more per- 
haps than is generally imagined, to save life. 
But so long as the causes of disease are left in 
active operation so long will diseases arise, and 
many of them will prove fatal under the most 
enlightened and skillful management by physi- 
cians. It istrae, the science of medicine is pro- 
gressive ; new discoveries are continually being 
made of means for the relief of the sick. But I 
doubt whether man will ever discover in nature 
remedies for all his physical ills. If he would 
avoid the penalties, he must avoid the sins. 

There has ever been too much bigotry and 
intolerance among the medical profession. Every- 
thing new, every innovation upon the established 



CAUSES OF [NFANT MORTALITY. 57 

practice, has met with the most determined oppo- 
sition from the allopathic school. The priests of 
that school have looked for their tenets to the 
dim, misty superstitions of past ages, instead of 
searching for them in the living present and 
promising future. Consequently they have be- 
come learned in the rubbish of superannuated doc- 
trines and theories instead of in the philosophy 
of nature and truth. Such men are bigoted, in- 
tolerant of all opposition, superficial, impractical. 
They strut and swell in society like great Goli- 
aths, imagining themselves the personification 
and embodiment of all wisdom. A vast number 
of such individuals exist amongst us to-day, but 
they are much less numerous now than they 
were in former times. The rapid rise and pro- 
gress, within the last few years, of the Eclectic 
system of medicine has done much to infuse 
into the profession a more liberal and demo- 
cratic spirit, and to expose many of the shallow 
theories and destructive practices that have pre- 
vailed for so many centuries among those who are 
pleased to style themselves " regular physicians." 
The Eclectics have modified the practice in many 
important features : they have almost driven 
blood-letting out of use. They have ever con- 
demned the use of mercury, lead, antimony, 
arsenic, etc., as poisonous minerals which act only 
as foreign substances in the body, to impair its 
vitality and sow the seeds of premature decay. 
And they are still laboring with the industry and 
zeal of philanthropists to induce all physicians to 



58 AN ESSAY ON THE 

discard them and use new and better remedies. 
They have discovered and introduced many new 
and valuable vegetable medicines, besides new 
modes of using old ones in curing the sick. They 
have done much toward rendering medicine a 
pleasant sanitary restorative, instead of a terror to 
the sick. Their practice shows a great reduction in 
the death rate. According to Prof. A. Jackson 
Howe, M. D., of Cincinnati, one will die out of every 
thirty cases of sickness when left alone to nature 
without the aid of medicine. " In homeopathic 
practice one dies in every thirty-three cases 
treated, showing a slight improvement of that 
treatment over no medication. In allopathic prac- 
tice one dies out of every twenty-eight or nine 
cases treated — a result which shows not that allo- 
paths never administer relief, or assist in perform- 
ing cures, but, as a whole, the fatality of that prac- 
tice is a trifle more than where no medicine is 
given. Fifty years ago, when every disease was 
attacked with a heroic system of depletion, one 
death occurred in every twenty-five cases treated. 
From reports lately obtained from several hun- 
dred physicians I am warranted in stating that 
in the practice of eclectics only one patient dies 
out of sixty cases treated. Besides the saving of 
life, it is reasonable to suppose there has been a 
corresponding economy of valuable time and ex- 
pense to those who have been sick, rendering the 
benefits received of still more importance."* 

*An address delivered in Indianapolis, before the State Eclec- 
tic Convention, by Prof. A. Jackson Howe, M. D., Aug., 1867. 



CAUSES OF INFANT MORTALITY. 59 

As the physician is the interpreter of nature 
and the dispenser of her blessings to the afflicted, 
it is his imperative duty to seek out the means of 
relief in every recess of her vast domain. He is 
the true physician who can lay aside all prejudice, 
and acknowledge truth wherever it is to be found. 
The man who confines himself to a set of text 
books, containing the written creed of a sect, and 
believes in them lies all the wisdom of the world, 
has an understanding too little to comprehend the 
broad domain of science or the depth of his own 
ignorance, and would better serve humanity at 
the plow than he can in the healing art. The cry 
quack, quack, quack! at every physician who 
refuses to square his opinions and practice by the 
tenets of the written law, or to ease his conscience 
at the confessional of a professional clique, has 
about ceased to command any respect among 
intelligent people. The people will judge for 
themselves, and give every physician credit for 
what he can do to restore the sick. Utility is the 
demand of rationalism, and rationalism is the 
demand of the age. The true spirit of the pro- 
fession is clothed in the majesty of truth and rea- 
son ; " suffereth long and is kind ; it envieth not ; 
it is not puffed up ; is not easily provoked ; think- 
eth no evil ; beareth all things ; hopeth all things ; 
endureth all things, for the sake of the sacred 
cause in which its generous philosophy is en- 
gaged." 



60 AN ESSAY ON THE 

This ends my essay. If I have contributed 
anything to the dissemination of useful knowl- 
edge, I am amply paid for the labor done. If 
there be any whose interests I have damaged, 
"him have I offended." 



.A. T IR, E .A. T I S IE 



PHYSIOLOGICAL MANAGENENT 



INFANCY AND CHILDHOOD. 



EMBRACING 



A complete system of Hygiene for the use of 

parents in rearing families, with many useful 

suggestions on the moral and intellectual train- 

of cJiildhood. By John W. Thkailkill, M. D. 

St. Louis. l<2mo. pp. 300. 

This work has been in course of preparation for 

several years, and will now soon be ready for the 

press. It is written in a plain, vigorous and easy 

style, and is designed as a popular manual on the 

subject for parents, and the young of both sexes, 

who are to take upon themselves the holy duties 

of parentage. The contents of the volume will 



62 AN ESSAY ON THE 

embrace everything connected with the rearing of 
offspring ; commencing with the parents before 
conception, it follows the young being through 
all its various phases of development, from con- 
ception through gestation, infancy and childhood ; 
setting forth, in the plainest words, the natural 
laws which govern and influence the physical and 
mental development of the child, thus rendering 
parents able to see for themselves, by the light of 
natural science, what is right and what is wrong 
in the management of their children, that they 
may pursue the one and avoid the other. It is 
not a medical book — it does not treat of the dis- 
eases of children — but its design is to instruct 
parents how to bring forth and rear up vigorous, 
healthy, intellectual and moral children, such as 
may be a blessing to themselves, an ornament to 
society and an honor to their country. The pub- 
lic will be notified in due time of the appearance 
of the book. 



